Gut microbial metabolite TMAO portends prognosis in acute ischemic stroke

Over the recent years, the role of trimethylamine N-oxide (TMAO) as a gut-derived metabolite mediating cardiovascular disease pathogenesis has been under particularly intense scrutiny. The aim was to explore whether TMAO levels were associated with clinical severity or functional outcome in Chinese patients with ischemic stroke. This is a single-center, prospective cohort study from Xiamen, China. We examined the relationship between fasting TMAO and 2 of its nutrient precursors, choline and betaine, vs. 3-month functional outcome and mortality in 351 first-ever patients with acute ischemic stroke. The median value of the plasma level of TMAO was 6.1 μM (IQR, 3.7–9.9 μM), which was higher than in those control cases (4.0; 2.4–5.9 μM). Patients with a poor outcome and nonsurvivors had significantly increased TMAO levels on admission (P